Download Managing Eating Problems In Cancer Patients

Managing Eating Problems
In Cancer Patients
Patient Information
Nutrition and Dietetic Department
Author ID:
Leaflet Number:
Version:
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LB
Diet 004
2
Managing Eating Problems in Cancer Patients
January 2015
January 2017
Managing Eating Problems in Cancer Patients
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Cancer and the side effects of its treatment may affect your ability to eat. These side
effects include:
 Loss of appetite
 Changes in weight
 Sore mouth or throat
 Dry mouth
 Difficulty to swallow
 Dental and gum problems
 Changes in sense of taste or smell
 Nausea/vomiting
 Diarrhoea/Constipation
 Fatigue and/or depression
You may or may not have any of these side effects. Many factors determine whether you
will have any and how severe they will be. These factors include the type of cancer you
have, the type and the length of treatment and the dose of treatment.
Recommendations about food and eating for cancer patients can be very different from the
usual suggestions for healthy eating. This is because they are designed to help build up
your strength to help you withstand the effects of your cancer and its treatment.
This diet sheet contains information to help make sure your food intake is as good as
possible and to give you meal and snack ideas to use until you are feeling better.
Difficulties in swallowing
Difficulty in swallowing may be experienced for a number of reasons including the type of
cancer or side effects of radiotherapy or chemotherapy treatment (dry mouth, sore throat).
Some suggestions if experiencing swallowing difficulties are:
 Eat small and frequent meals
 Mince, blend, puree or chop your food, but try to make it look appetising on the
plate
 Go for soft, nutritious foods such as thick and creamy milk yoghurts without fruit,
soft scrambled eggs, thickened broths and cream soups
 Try pureed or mashed fruit and vegetables
 Ice-cream, custard, thickened juices and thick milk shakes
 Using a straw to drink may help
 Moisten foods with sauces and gravies to make them easier to swallow
 Take small bites and chew your food well
 If you have a sore mouth, try to avoid foods that can irritate your mouth. These
include:
- Citrus fruits and juices
- Spicy/salty foods
- Raw vegetables and dry foods
- Commercial mouth washes that contain alcohol
Managing Eating Problems in Cancer Patients
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Loss of appetite
Poor appetite is one of the most common problems that occur with cancer and its
treatment.
 A small drink of wine or sherry before meals helps to increase the appetite, but
check with your doctor first if you are on medication
 Try frequent small meals throughout the day
 Make meals as attractive as possible with garnishes, e.g. parsley or other fresh
herbs, tomato, lemon as appropriate
 Nourishing drinks can be used to replace some meals (see page five)
 Make foods such as soup, mashed potato, sauces and milk puddings more
nourishing by mixing in milk powder, cream, evaporated milk, grated cheese or
butter/margarine
 If you are too tired to prepare a meal, have a ready meal instead
 If food has no taste, try highly seasoned or marinated food
 If you are unable to tolerate hot foods, eat food cooled to room temperature or when
cold
 If you find cooking smells a problem, avoid the kitchen or use cool or microwaved
foods
 Try not to drink fluids during meals as it may make you feel full
Weight loss
Little and often is the best way to increase your calories when you notice any signs of
weight loss. Aim for three small meals and three snacks daily. You can also add high
energy foods to your meals to increase calorie intake.
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Add margarine/butter or cream to mashed potatoes and vegetables
Add extra sugar to drinks, cereals, desserts and fruit
Add honey, syrup or jam to porridge and desserts
Add grated cheese to potato, vegetables or soup
Add mayonnaise to salads and sandwiches. Add cream to soups, sauces and
desserts
Include cream cheese on bread and biscuits
Make fortified milk (four tablespoons of milk powder mixed into a pint of milk) and
use this for your drinks and in cooking
Feeling sick?
Some types of chemotherapy or radiotherapy near the stomach can make you feel sick.
This should be temporary, but is upsetting and can affect your ability to eat well.
If you feel sick or are being sick, your doctor may prescribe you some anti sickness tablets
(anti-emetics).
 It is important to eat when you are feeling sick, even though you don’t feel like it!
Eating may help to settle your stomach
 Try to eat little but often
 Give yourself plenty of time to eat and ensure you are sitting in an upright position
 Have something dry like a biscuit first thing in the morning
Managing Eating Problems in Cancer Patients
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Don’t eat fatty or highly spiced foods
Keep meals fairly dry and drink an hour or so after eating. If you are feeling sick in
the morning or after a nap, try to have foods like toast, biscuits, crackers and crisp
breads
Try cold foods and drinks
Acidic flavours like chilled tinned grapefruit are easier to take
Try ice lollies or fizzy drinks such as lemonade, cola or Lucozade or fruit juice mixed
with soda water or lemonade
Drink plenty of fluids
Try salty foods
Ginger flavoured foods can also help to reduce nausea
Drink through a straw
Keep away from the smell of cooking
Wear loose clothing
Have plenty of fresh air in your room
Try to go for a walk before meals
Diarrhoea
Some chemotherapy drugs, radiotherapy to the gut, pain relief medicines, antibiotics and
anti-nausea drugs can affect the lining of the digestive system and cause diarrhoea.
During diarrhoea, food passes quickly through the bowel before your body has a chance to
absorb enough vitamins, minerals and water. This may cause dehydration.
 Drink plenty but not with meals; don’t become dehydrated
 Avoid fatty foods
 Avoid high fibre foods for a while, e.g. bran, peas, beans
 Don’t have very hot or cold foods and drinks
 Eat little and often
 If diarrhoea persists seek medical advice
Constipation
Some anti-cancer drugs and other drugs such as pain medication may cause constipation.
This problem also can occur if your diet lacks enough fluid or fibre, or if you have been in
bed for a long time.
 Try to eat regular meals
 Drink plenty of fluid – at least six to eight glasses daily
 If wind is a problem, avoid carbonated soft drinks
 Eating more fibre may not be possible for everyone, if you find that it does not agree
with you ask your dietitian for advice
 Try to be as active as you can
 If constipation persists seek medical advice
Heartburn and reflux
This side effect is also very common in cancer treatments. There are medications that may
help the problem. Seek medical advice if the problem persists.
Managing Eating Problems in Cancer Patients
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Have small regular meals
Don’t drink immediately before eating, and wait 30 minutes after eating before you
have a drink
Chew your food well
Sit upright when you eat and stay like that for a little while afterwards to help the
food to go down
Peppermint sweets and/or peppermint tea may help
Avoid fatty or fried foods
Don’t eat within one hour of going to bed
Drinking milk or eating yoghurt may help
Changes in taste and smell
Cancer and its treatments can cause changes in your senses of taste and smell. This can
make your favourite foods taste or smell unappetising.
 Rinse your mouth frequently with water
 Use plastic cutlery to reduce the sense of metallic flavour
 Use fresh fruit and vegetables in meals instead of tinned
 Season foods with tart flavours such as lemon, vinegar, pickles, however, be
cautious if you also have a sore mouth
 Use spices such as garlic, chilli, basil, oregano
 Serve foods cold or at room temperature
 If you cannot tolerate red meats, try other high protein foods such as poultry, fish,
eggs or cheese
 Chew a few peppermint or spearmint leaves or drink a cup of peppermint tea to free
the metallic taste after eating
Nutritional supplements
If you are struggling with your diet or your body needs more nutrition than your normal
meals provide it may be necessary for you to take nutritional supplements. Your dietitian
can recommend prescribable supplements and arrange these with your doctor. Remember
there are lots of ways to drink these, and they can also be used in cooking.
How to take your supplements
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Your dietitian will advise you on how many supplement drinks to take each day
It is best to have these drinks after or in-between meals or in the evening. If you
take it just before a meal you may find it reduces your appetite and you are unable
to finish your meals
Most of these drinks are best served chilled although they can also be heated
gently. Remove from carton/bottle before microwaving
Do not boil supplement drinks
The drinks can be sipped through a straw from the bottle/carton or poured into a
glass
Managing Eating Problems in Cancer Patients
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The drinks can be frozen into ice cubes or lollies if preferred
Remember: these products are meant to supplement your diet and not replace ordinary
food.
How to store your drinks
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Check the best before date on the supplement drink before use
Prior to use, supplement drinks should be stored in a cool dry place
Once opened these drinks should be stored in the fridge and any unused portion
discarded after 24 hours
If the drink is left at room temperature it should be discarded after 4 hours
To help meet your nutritional needs it is recommended that you take the following
supplements:
Supplement drink
Daily quantity
It is recommended that you should continue to take these for _________ weeks/months.
Your Dietitian is ____________________________________
Contact details: _____________________________________
Managing Eating Problems in Cancer Patients
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Comments, Compliments or Complaints
The Patient Relations/PALS Department provides confidential on the spot advice, information
and support to patients, relatives, friends and carers.
Contact Us
Tel: 01942 822376 (Monday to Friday 9am to 4pm)
The Patient Relations/PALS Manager
Wrightington, Wigan and Leigh NHS Foundation Trust
Royal Albert Edward Infirmary
Wigan Lane
Wigan WN1 2NN
In addition to the Patient Relations/PALS Service, you can contact HELPline on 01942 822111.
This leaflet is also available in audio, large print, Braille and other languages upon request.
For more information call 01942 773106.
© Wrightington, Wigan and Leigh NHS Foundation Trust
All rights reserved. Not to be reproduced in whole or in part without the permission of the copyright owner
Managing Eating Problems in Cancer Patients
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